|
19.2.4 Bone-Anchored Hearing Aid (BAHA)
A bone-anchored hearing aid (BAHA) may be a benefit of the CSHCN Services Program for clients who are 5 years of age or older and who meet medical necessity criteria. The following procedure codes may be reimbursed with prior authorization.
Replacement batteries for the BAHA may be reimbursed using procedure code V5266 and do not require authorization. Replacement batteries are limited to clients with a previously-billed hearing device. Replacement batteries for clients who did not receive the hearing device under CSHCN Services Program benefits may be reimbursed on appeal with a physician's statement documenting medical necessity.
The BAHA is Food and Drug Administration (FDA)-approved for clients who are 5 years of age or older. Clients who are younger than 5 years of age do not have sufficient bone density for implantation of the device.
The following provider types may be reimbursed for the BAHA device and services:
• Physicians
•Audiologists
•Home health DME
•Medical and DME supplier
•Custom DME providers
•Ambulatory surgical centers (freestanding/independent and hospital-based)
•Hospitals
|
